HomeMy WebLinkAbout427 WALNUT PL - Building Permits� f9
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CI� Y OF C�'�STA MESA �
BUILDING D/VISION
77 FAIR DRIVE, COSTA MESA, CA 92626 • p74) 754-5273 • Fax (714) 754-4856 • wviw.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754•5626
PERMIT TYPE:
Sub Type:
JOB ADDRESS
APN: 42631216
Vicinity:
Const Type: V-B
B COMBO
RES ALT
427 WALNUT PL CM
SQ. FT:
Zoning: , ,
897
r'. �
PERMIT NUMBER: BC09-00482
STATUS: ISSUED
DATE ISSUED: 0 112 2/2 01 0
ISSUED BY: CAC
Suite/Unit:
Primary Occ:
Valuation: $49,000.00
SCOPE OF WORK: ADD 252.5 SQ FT TO FIRST FLOOR TO EXPAND LIVING ROOM AND BEDROOM. ADD 64 SQ FT COVERED
PORCH AT FRONT OF RESIDENCE. ADD TWO NEW 5' W IDE ROOF DORMERS. ADD 544 SQ FT ATTACHED
CARPORT/BREEZWAY AT SIDE OF RESIDENCE. NO NEW RESTROOMS OR BEDROOMS. NO NEW PLUMBING.
2 LIGHTS, 10 OUTLETS
OWNER: BLOCKBURGER,GARY
Phone: 949-646•5749
APPLICANT: KENT, ART
Phone: 702•335•9958
CONTRACTaR:
Phone:
Celi:
ARCHITECT: ARHTUR KENT
ENGINEER: F W ENGINEERING
Address: 427 WALNUT P�
City/State/Zip: COSTA MESA, CA
Address:
CitylStatelzZip:
Address: Unit:
City/State:
License No.C15748
License No.2025
COMBINATION PERMIT FEE SUMMARY
Building Plan Check: $412.20
Building Fees: $634.15
Electrical Fees: $36.70
Mechanical Fees: $0.00
Plumbing Fees: $0.00
SMIP Residential: $4.90
SMIP Commercial: $0.00
Bldg Std Admin Fund $2.00
TOTAL FEES: $1,089.95
"Rafor to tee rnceipts (or all fees paitl /or projoct
m
License No.
UniL'
,r`��;-O�i�+o:?
Unit :
ZipCode
PHONE:714-969-6306
PHONE:714-832-0250
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NOTICE: The vrork aulhorized by this pertnit shaft comply vrilh atl appticable handicap access requirements under Califomia stafutes and related
regulations. (Ord. No. 92-28. § 1, 12-21-92) �
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. "
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspeclions and final approval will result in the expiration o( this pertnit.
GOpEp. INSPEC7IONME ORT�F N RL COOEI INSPEC710NTYPE DR�,F �(-�� IN1111A
1878 Fixetl System Final Fire Prevention 206 Final Mechanical �'c7 �% lV� y�N�v3L�
1268 Pool Spa Final 208 Final Plumbing 6-as-ia 6Ly NM ���
200 Final Re-Roof 210 Final Eledrical �"C�rY/l) �V��+�
201 Final BIocWRetaining `/�all
202 Final Facmry Fire Place
203 FinalSign .
204 Final Demolition
212
220
Final Fire Prevention
Final Planning Approval
222 Final Sile
250 FinalBuilding/Occupancy,
: 1 �'
�-as-�a e, �Z�
WOIfiCERS' C'DMPENSATION DECLARATIO�
I hereby aHirtn under penalty of perjury one ot Ihe following declarations:
❑ I have and will maintain a certificate of wnsent to sel4lnsure (or workers'
compensation, as providetl for by sec[ion 3700 0( the Labor Code, for the
pedormance of the work for which Ihis permit is issued.
❑ I have antl will maintain workers' compensation insurance, as requiretl by
section 3700 of lhe Labor Code, far lhe peAortnance of Ne wwk �or which this
pertnit is issued. My workprs' wmpensation Insurance cartier and policy
number are:
Carrier.
(T�is secY.on need riw De mmp�eletl F t�e pe�mrt is relueE at me nvnOrad doFars (E�001 w less 1
Policy Number:
❑ I ceAify that in the pedormance of the work (or which this permit is
issued, I shall not employ any person in any manner so as lo become subject
to the vrorkers' compensation laws of Califomia, and agree Ihat if I shoultl
become subjecl to the workers' compensatlon provisions of Seclion 3700 0(
the Labor Cotle, 1 shall (orthwith wmply wiN lhese pmvisions.
Apdimm's Si9ev�Wre Da�e
WARNING: FAILURE TO S�CURE WORKERS' CAMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FIN�S UP TO ONE HUNDRED THOUSAND DOLL4RS
($100,000), IN ADDITION TQ THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am lic�nsed under pmvisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business antl Prolessions Code, and
my license is in full force and eftect.
Lic. # Class #
Gontractor's
CONSTRUC710N LENOING AGENCY:
❑ I hereby aKrtn that there is a construc(bn lending agency (or the
peAormance of the �wrk for which this pertnit is issued. (Sec. 3097. Civil Code).
lender's Name:
Lender's Atltlress: _
Si8^aWre
OW NER-BUILDER DECLARATIONS:
I hereby aKrm that under penalry of perjury that I am EXEMPT FROM THE
CONTRACTORS IICENS� I,AW lor lhe (ollowing reason (SCL. 7037.5,
Business and Professions Code: Any ciry or county wliich reQuires a permit to
conswct, alter, improve, tlemolish, or repair any structure, prior to its
issuance, also requires Ihe appliwnt tor such pertnit to file a signed statement
Ihat he or she is licensetl pursuaN to the pmvisions of �he Contractors
License Law (Chaprer 9(commencing with Section 7000) of Division 3 of the
Business antl Professions Code) or that he or she is exempt therefrom and
the basis for the allegetl exemption. Any violation ol Section 7037.5 by any
applicant tor a permit subjects tha applicaN to a civil penalty ol not more than
fve hundretl tlollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not intended or
ofteretl for sale (Sec. 7044, Business and Professions Cotle: The Contractors
License Law dces not apply to an ovmer of property who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, providetl Ihat such improvements are not intended or oflered for
sale. If. hovrever, the builtlinq or improvement is sola within one year of
completion, the owner-builtler will have Ihe burden of proving that he or she
�tlid �not build or improve for purpose of sale.).
�J\I, as owner of Ihe prOperty, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRAC70RS lo construct the project (Sec. 7044. Business and
Prolessions Code: The crnlractors License Law dces not apply m an avner of
property who builds or improves thereon, antl who wntracts fw such project with
a cmtractw(s) license pursuant to the Cont2ctors License Laws.).
❑ I am exempt untler sec.
BuSiness and Piofessions Code for this reason:
1
�. �. .'7'� r�'/���: � .► �N�L 1
s:;'� '
� . �
� Ovmer verifed by tlriver s license. es ❑ No�'�
Driver' wice e No.%� ��% cxprtes: ��/Lq �/3
Venfica ion ol Ownership by (rype of document, i.e. - pmperty taa bill or �eed):
OIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certily ��at no excavalion (rve (5) or more feet in depth into wfiich a
person is required ro Descentl, will be made in connection vJ�th v.ork authorizetl
by this permil, antl that no building structure, scaFfdding, false.wrk, a demolilion
or dismanNing thereo/, vnll be more than thirtysiz (36� (eet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Ttle 8, California Administrative Code�.
❑ As owner-builder, I vrill not employ anyone to tlo vrork which would
require a permit Irom the Division of Industrial Satery, as notetl aDove, unless
such person has a permit to do such work from Ihe division.
ApP��W^�'s Signalore
Division ot Industrial Safely Permil Number:
HAZ/1RDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicaN or present or future Duilding occupant need b file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of lhe Calilornia Heallh and Safety Cotle requires, with some
exceplions, thal a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time tluring a reportetl
year a quantily of hazardous materials equal to or greater than a vreight of
500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas
al standard temperature an0 pressure).
2. Does or will lhe applicant or present or tuNre building occupant need ro file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Satery Cotle, vnth some
exceptions, requires registration with [he Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weigM o( 500 pountls, or a
volume o( 55 gallons, or 200 cubic feet of compressetl gas at standard
temperaNre and pressure�.
3. Does or will the applicant or present or (uWre building occupaN need to
prepare an RMPP (Risk Managemen[ and Prevention Program lor acutely
hazardous materials)7 ❑ Yes ❑ No
(Sec[ion 25534 of the Calilornia Health antl Safety CoOe provides Ihat Ihe
Costa Mesa Fire Department may require the preparalion, certifcation and
fling with the Fire Deparimenl of an RMPP by businesses which are required
to regisler acutely hazartlous matenals with the Fire Depatlment.
4. If an RMPP is presently required, �as Section 25534 ot the Calitomia
Health and Safety Cotle been lully complied vnth? ❑ Yes ❑ No
5. Does or vdll the applicant or present or fumre builtling occupant require tor
lhe vrork which i5 Ihe 5ubjecl o( this application a permil (or such wnstruction
or modification from the Sout� Coast Air Quality Managemenl District or !mm
any other air pollWion coNrol districl or agency? ❑ Yes ❑ No
(Sectbn 65850.2 of the Calilomia Govemment CoOe requires that the reque5tetl
information be fumished on applications fa rwn-residential buildirg pertnits).
6. Will any pah ol Ihe faciliry to be constructetl untler this pertnit be vrithin
1000 feel (rom the outer boundaries of a school? ❑ Yes ❑ No
(I/ "yes", the faciliry must meet the requirement of Sections 25534 and 42303
of the Califomia Heallh and Salety Code).
7. If a permit from Ihe South Coast Air Qualily Management District or other
air pollution coNrol tlistricl or agency is required for the work which is the
subiect ol this application, have all of the disclosures prescribed by Califomia
Heal[h antl Satety Code Section 42303 been made7 ❑ Yes ❑ No
8. Qf "yes", attach cetlifcate of compliance from the appropriate air polWtion
control offcer�.
CERTIFICA7E OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correcL I agree lo wmply with all slate laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre Da1e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this appliwtion and state that
the information given is correcL I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
the Ciry of Costa Mesa to enter upon the abovetlescnbed property for
i pection purposes. a ee not to occupy or allow occupancy of any building
riz d by i p r nti f al' spection.
Igna mells) �
a�a�« aumwzec apw����
COUNTY OF ORANGB
BUILDING DHPT.
636 No. Broadway
Santa Ana� California
� Phone: KI 2-6211
� ��
E
0
e
a
Application for Building Permit
AND FOR A
Certif�cate of Use and Occupancy
1. OWNCR'S NAME.--_--_Y--.-- _._-f-�i'-
MAILIIVG ADDRES ___.____../w-�__
Name _ ____.____-___...
(Archicec[ or Engineer)
Address--,-----�------------------------------�
City --
State
Lic. No.
Phone
�—,
Address
City -__-
$tate
Lic. No.
Permit No_�� ���
Date--------/����ltl�- _._.----------
� ----------- PHONE: �------�'---��/
-- CITY _ L�ia��. ..
(Contracror)
Phone ..
PROPOSED USE: - - -'�i7---= - �"�'r�v—��-�:-=---- ------ ---------- --------- - -- --- _ - - - --- - ------- - --- -
--- -7 � !N
2. • J OB LOCATION.-- --- --'S/� f- ---- ------------ -------- - ----- --- ----- ----- -------- --------------- ---- --- ----- -- ------------ - -
(House No.) (N/ame of S[reet) (Town or School Districo)'/
. 3. LEGAL DESCRIPTION: Loe ___ �. . ._ .! .____....____Block ..______.__.___ _ ___Tract _ �`Y�a% ��
7 - -- - ----- - -`� - - - ---- ---
(Meres and Bounda Descripcion—Use resedse side of form) ,
4. CORNER LOT ( ) INTERIOR LOT (✓) THROUGH LOT ( ) SLOPE OF LOT ( )
5. SIZE OF BLDG.: eZ.tQ.Y._��AREA:___/.�_`.D_____._...,SIZE OF LOT:_%Z_�r_/s2 L7_AREA: _Z�QII-----------
. ♦
6. HEIGHT OF BLDG.: __-__�G------------CEILING HEIGHT: __._.�.___________. NO. OF STORIES.___f...___._.____
i. NO. FAMILIES.___________ ��-.E_�� SizeoEKitchen:..�Q_.k_/Q�'
f-__-______---.Size of Smalles[ Bedroom: _-- -_--- ___- - _---__-
S. EXTERIOR WALL CONSTRUCTIOIV:__�i�G�..T______..__INTERIOR WALL COVERING __.__�._______
(Frame, Stucco, Ecc.) � / (Plascer-0rywall, E�c.)
9. SETBACKS: Front Yard £rom Center Liae of Street.____�Q"_'—_______._ __________.________.____________._____________._________.__.
Nearest Side Yard.___._V�.��_,_�Rear Yar3.__.7'Q..._/istance in Feet Between Bldgs. on Same Lot ___..�a____�__�___..__.
�
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AIVD USE OF EACH.
l/ �
_�_______________ De th in Ground.___�- ___.__._Width of Wall _. _..._i _
11. For (a) Footing: Width ____/�(p_ p �. __.__.__
Atcessory
Bldgs. and Z, J, ° ' /
Similar (b) Size of Studs: ____ 2C_T�___..Spacing._..__._.._J�......___. _"CC Material of Floor .L.{,/_ __ __ ___________
Structures: p �/ 7
(c) Size oi Floor ]oists: ---_-Z�c_1J.._---_------.Spacing -___ ---�-_----____-___"CC
/ ,/ b
d Size of Rafters: ___-._-2-aL_�t _---_-'__'--.5 atin 2 __-________"CC
( ) P S ----------`�`
12. VALUATION OF PROPOSED WORK: Induding all labor, plumbing, elec[rical wiring, heating, fire sprinklers, paina
ing and sewage disposal $___����-•_m0__A_.__________""__ . .
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN
THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL
LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
� Sign
Plans Filed: ----------------- ----�--✓--------------------
Btdg. Pen„it
P(an Check
Total - -
Receipt No.
Paid ro
Dace ---------
FEES: �
- �---��'P-
� ,�,tj-----
- $ - - -- ---- ------
FOR DEPARTMENTAL USE ONLY
GROUP ----�- ---- - --
TYPE--- .��--- - -
DIST.
MAP- - - - --- ------ --- ---
SHEET NO.______.�..._.____
OEC 1 4 j°�
DATE--------- ----------------- ----- ---------
�"-''� !D�/3
�r���KING BY
APPLICATION__ ._� . HEALTH_____.___.._.._______.
c��� FIRE
ZONING_____'____.__.. MARSHAL
PLANS AND
SPEC'5.--_____________- STATE ------..
CORRECTIONS EIVGINEER
VERIFIED ----------------- CAL.._....----
�(�'�qg�g�, 1� r COU��IT'i BUILi:�ING
PER l�. ';'d. LI�.J��: +��i_� ip�s�5::1'OR
--"-_-" -- -- - j"j - - - - ------D=PfJT-K----------- ----------
��.
COUNTY OF ORANG6
BUILDING DEPT.
636 No. Broadway
Santa Ana� California
Phone: KI 2-6211
1. OWNER'S NAME.
MAILI[VG ADDRE
Name... ..._____.._.______.
Address ---------------_--
City-- `-----'_" - - --..
State
Lic No..-'-----_...__-'--
PROPOSED USE:.
2.
3.
u
Application for Building Permit
AND FOR A
Certificate of Use and Occupancy
(Archirecc or Enginee-)
Phone
Name.___.
Address
City _-__.
State
Lic. No.
,iy��
JOB LOCATIOA'_--(,/ -- ��%-- w"^-r""'
- ----------------------------------..__
(House No.) (Name of Streec)
LEGAL DESCRIPTION: Loc ___�_�_;____�____._.___.Block
(Meres and Bounds Descripoion—Use reserse s�de of form) .
PermitNo....,1 �! � v
---------- - - --------
------- PHONE:._�.-yZ9/
CITY -- - -- - -- ------------------ ---
(Contcactoe)
(Town or School Dis�rict)
- - ---------T�a« . --�5�2 G ---� -
4. CORNER LOT ( ) INTERIOR LOT (� THROUGH LOT ( ) SLOPE OF LOT (
5. SIZG OF BLDG.:_LO .i�-eZO--.AREA:__.��o-�----------_....-_SIZE OF LOT:.__�� y._.LCIa__AREA: �.2-Q.�2__.________
6. HEIGHT OF BLDG.:.____.1_�_�__�_ ____CEILING HEIGHT:._____.___'-"____________ NO. OF STORIES..____I-____.___
7. NO. FAMILIES ___..___ _____.___________..Size of Smallest Bedroom: _..__-__`___________ Size of Kitchen: ...__..___"'____..._ _._____
8. EXTERIOR WALL CONSTRUCTION:__��y_________INTERIOR WALL COVERING _._____.'-____________________________
. (Frame, Sm<co, Em.) f (Plas�er-Drywall, E[c.)
i�
9. SETBACKS: Fronc Yard from Center Line of Street..____......�_�� -�
_______________________________________"_______'__'____"___ _______ __
/ /� � /
Nearest Side Yard___ �_______.Rear Yard___.F���.___.__...Distance in Feet Between Bldgs. on Same Lot ___./_�____________ __.____
1G. A COMPLETE PLOT PLAN IS REQUIRED, SHOWI[VG ALL STRUCI'CJRES AND USE OF EACH.
'/ � �+ s
11. For (a) Footing: Width ___ f'Y".______..___._ Depth in Ground____..�.�.,__.____._.Width o£ Wall .�_....___._
----
Actessory
Bldgs. and Z '/ '
(b) Size of Studs: _____ -?�- T-_--.Spacing...._-.---- - - --�____
Similar / -------"CC Material of Floor ....
Strucmres: �
(c) Size of Floor Joists: -_-_-_-___---.-_-.'--_---__Spazing ._--_-_- -__- -___-___"CC
d Size of Rafters: __._ �.__y.__4�_________________S au.n "
( ) P S - - -�� - y----- --- CC
12. VALUATION OF PROPOSED WORK: Intlyding all labor, plumbing, electrical wiring, heating, fire sprinklets, paint-
ing and sewage disposal �_-7Zp..�_90-._---_�_.----_-------_'
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN
THIS APPLICATIOIV IS CORRECT AND THAT THE CONSTRUCTION WQRK WILL CONFORM TO ALL
LA�X�S OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
. �j� `
� Signed:.------ --- -- -�_�!_-'- --- ------------------------------ ------------------------
• Owner)
Plans Filed: ------------------ ---------------
----------------- gY;.---------�----- - - - - ----'-------------------------------
.
--- -- - - - --- - -
(Auchori ed Agen[)
FOR DEPARTNiENTAL USE ONLY
Bldg. Permit
Plan Check
Total - -
Receipt No.
Paid ro
Date ---'- '___
DA
SM-9-50
GROUP---- 4��--- --
- --
TYPE ------- --------�. -
DIST.
MAP-------- - -----,p-- �- - - ----
SHEET NO.____�f'--��.____.____
��ING BY
APPLICATION�_ _ HEALTH___________..___.
- FIRE
ZONING--- ------------- - MARSHAL--- -- - -- ---
PLANS AND
SPEC'S------------------------ STATE _.
CORRECTIONS ENGINEER
VERIFIED ------------------- CAL.--------
PERMI , iI- coun:�v e�i! DING
JEC j ft SVSO � • � il�O �Ji � INSPECTOR
�EPUTY r
V
'�ecT RQDBESB: 9 z7 WALN�I�L
owxtlt^aM�Me: gLOCitHURGHR, GARY
�noxcss: qZ� WALNUT PL
COSTA MESA,CA
646-5799
1flCHlENCIMEEH:
�oneess:
UNIT:
92627
neo.xo.:
uxrt:
PEPMITTEE: GARY BLOCKBURGER ( 719 ) 696-5749
ROOflESS: 427 WALNUT PL
CM CA 92627
110EN5E0 CONTMCTOB OECUMTION: I �ereby affirm Itwt I am IicenseA unEer pmvisians oi Clwpter 9(commencinp wiN Section
7000) ol Oivision 3 oi Ihe 6usiness anG Pmlessions CoOe, an0 my license Is in lull force antl ettect.
cm uc.: sTare uc.: cuss:
Oate: � Sipnatum:
WOBNEBS' COMPENSATION OEClAl111TI0N: 1 hereby affirm ihat I have a certilicate of cansent ro self-Insure or a certificate oi Workers'
ComDensation Insuance, or a cetlitied capy tAereof (Sectian 3800, Lah. C�.
PoLICY XO.: F1IP. O�TE:
Cetlifie0 coDY is hereEy tumished. ❑ Cerlilie0 coDY is IileO vn[h t�e cRy BuilCinq Division.
y .;e: ApDlicant:
IXEMPfION FlIOM V/OflKEIi$' COMPENSInON OEpAIN710N: (ilu5 seclian �eE n0t 0e wmplele0 tt tlre pemit is �a ona �unOreO (51UD) or less�.
I ceriity Ihai In Ihe pertormance ol Ihe vrork �or wNch ��is permli Is ISSueE, I 5hall no� emplo ny person in a anner to as ro Gewme
� suhjed to the Y Erkers' � mpensalion Laws of Califomu.
Oate: �� SipnaNre� °�"9
NOTIC : It, atler malJnq this OeclAration, yau shoul0 Oecoma subject ta Ihe Workers' Compensation provis s al the La6or
CoOe, you must torthwitA comDly wilA such DroWsions ar tNs perrtut slwll Oe deemeE revoketl.
CONSTNUCTION LENOING RGENCY: i here�y atlirm t�at t�e�a is a construction IenOinp aqency for IAe perlormanca of Na xrorN for
which iAls De�mit is Issuetl (Sedion 309�. Civ. C�. •
IENUEN:
FOUHES3:
OWNEB BUILOEP OECIAMTION: I hereby aHirm ihat I am exempt irom the Caniradors' State License Law for tAe followin0 �eason
(�cUon 7031.5 Business an0 Pmiessio�y Cade: My ciry oi counry x1tich rtquires a perm%ro consWp. alter, improve, Oemolisn, or
repair a'ry structure, prior ta its iuuance, also reQares IM apD���nt iw such permit ta lile a siA�� statement that hNsl�e k IkenSeE
pursuant ro Ue prmdsions of tAa ContrzC�ori State License Law (CAapter 9(wmmendnp vritn Secnon 7000) ol avision 3 0l tne Business
anC Professions CoAe) ar thal hUsha is eKemp[ inereirom an0 Ihe �asis for tha alleAetl eKemD��on. My Nolation al Section 7031.5 Dy
any aD0licant br a Oermit su0jmts ttre aVDticant ro a civil penalry ol not more Itun Irve AunOreO ONlars (5500�.
I, az mmer a1 Ihe pmperry or my em byees wlt� xapes az I�eir wle campensalian, wiil Oo Ne work, antl iM
❑ slmcNre is nol intenCeG or ofleleE for sale (��ion 7041, Buuness anE PmlessiorW Cotle: T�e Contracrors' State Licenu Law
Aces not apDh �a an owner ol a D�oDerry who buil0.s or improves Ihereon, anA wAo Ooes suc� �vork himsell/hersell or Nroup�
his or �er own empbyees, OrWiAeO IAat such imDrmements are not inten0etl o� ottere0 lar ule. II, I�owever t�e 6uiltlinp or
improvemenl is mIU miNn ane Year of camDletlon, IM owner vnll Aave the 6urU¢n of provuip Aalshe EiE not EuiIE or ImD��'e
lor ihe Durpose of salel.
� I, as awner ol the pro0erry, am exclusively coniractinp with IicenseG coniractors to mnstmc[ t�e Droject (Section 7014, Business
L� and Prolessions Code: The Conlrac[ors Staie licensa Law Oces not apply ro an owner of property who CmIOs or imOrwes tAereon
an0 who coniracis lor such prol��'M!h a contractor(s) license Dursuant to ihe Cantractors' State License Law�. I am axzre
that proal al tAeii WOAer's Compensatmn insurance s�au10 be pmvi0e0 to me.
� I,am exemD� under Section: H p'J Q Q Q e. a v. C.
mrthisreason: ALL WORK bY OWNER�
Date: G owner.
I Oo nereCy cenity fW[ I am aware ot a�a unOersldn0 ihe requiremenis of Calilomia Healih a Satery Cade Section , 5533, anC
2553a anE rtut I or any hrture Ouiltlinq Oaupant vrill/will not (drde one) neeE to compty xit� saitl state w0es anO t�e reQuiremenis lor a
permit tor constmction or modificauon ��m t�e Nr Uualiry ManaOement 0.sinct. Nesitleniul canstructlon aDDliratlons are exempt trom
lheu D�ions.
Daro: MD�nt:
I nereEy cenify tAat I have rea0 t�is a00lication ana stata Iliat Ina aGove in/armation is corrat I aprea to wmpry all riry anO caunry
orEinances anG 5VVVt���aia laxs reWtinp to huildinp constructwn antl �ereUy autlanze reD�euntatives oi [his ciry nte tM abovo-mentioneC
praDerty lo�ctlon n/moses.
� Date: y �Zf�— SipnaWre:
oriver's Licensa or Socia� secunry er
166t�8 W�ite—BuilEing; GreerCaCe Enlorcament; Canary—Applicant; Pink—Revenue; GOIEenrotl—lweaaor
CITY OF COSTA MESA — BUZLLING PERMIT PERM NO: BP 098950
PERMIT NO: BP 048950 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; V—N PERMIT TYPE: PLU STR PURPOSE: OTH
JOB DESCRIPTION ; NEW SINK, BAYSSLIDING FR DOORS SQ FT; 360
CLAIM VALUE: 660.00 CALC—VALUE; 360.00 GROUP OCC: R-3 /
COMMENTS: NEW SINI(, HAY WINDOW & SLIDER
*�t�r*-x**�*��t+r�t##x* X##*�t*#*�**�et-x-**w+r*#�-�t*x�*�t*�r�r�x-*��x--x�*+t*�t�e#�x��##*#�t�t��r*�r�t�r+r*it*�r#*
Z O I3 I N G R E Q U I R E M E N T S
s�rBAcxs
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT 2N FRNT: FT IN REAR: FT IN
LEFT: FT IN RGFIT: FT IN LEFT: FT IN RGHT: FT IN
PARI{ING REQ • PROV: PARCEL: 42631216 ZNE; REF NO:
PLANNING NOTES>
i '
�#,rce**x*�e�*�r�*****�r+r#�###***�#***�r�*�r****�r*+�*��*�#�***x��rx*�*��rxx�����r�*�*�+r#*�
D E V E L O F M E N T S E E2 V I C E 5:. R E Q U I R E M E N T. S
ZONING APPROVED HY ;::: • DATE:
BUILDING APPROVED BX'�: DATE:
. — . � .. �7 . �.
APPLICATZON
ifiEiE#iEititit#�)EiliE
LEGALI2ATION;N
TE:
ikiF�tiEikitit)k!E' �(-ihitiEiliFiEiF�lF3fik3kiE�F#iEiEitlFitiFik9ElEiEitiE#iEiF�)fihdEiFlf9EdEiEiE�IE
F E E ', U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTI'TC MECHANIC FIRE SMIP/RES GRADING
PERMIT 15.00 2,00 50
25E „� SMIP/NON—RES
PLAN
ISSUE FEE 3,00 ���
bUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 17.50 3.00 �.' 0,00 20,50 20.50 .00
REVENUE DIVISION TOTALS--> COLLEC'�ED: 20,50 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
15,00 5.00 � ' ,50
�t iE if iE iE �lf- i! i!� iE iE it it it iE 1F ik # 1h if if ik ik 3E �E it iE iE # it ik iE iE iE iE iE it iE if�i! jE ik if ik iE iE iF iE if iE iE �1F iE fE iF tE if !t if iF iF it iE iFlk iE iE iE ih iE i! fF it i'r 4 ff # it �l! iE
I N D I V I D U A L �'�' E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N'� UNIT COST TOTAL COST
SFR 360 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 360.00
PLU 1 SINK, KITCHEN �_,2.00 2.00
END{OF FEES 1
�w
�
SMOKE DETECiC7R ,': ,' � SEP 11 �s90 � �
R�QUIRED ^. �: �
G7Y OF COSTA MFSR�
` ' 1 I
• � �
CONSTRUCTION ANDPLANNING " POOL. A
. APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
�1. Temporary Electriwl Service or Pole 52. Pool & Equipment Location - ��-,
2. Soil Pipe�Undrgrnd. .� 53. Steel Reinforcement �
.
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPflOVAL TO COVER�GUNITE
7. Footings � 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test ��
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. „
10. Structural Floor Svstem 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap � 63. Heater & Vent�Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical�Final �
.
15. Rough Electrical-Conduit ', 66. Solar System-Final ,
16. Rough Electric Wiring 67. Fencing & Access ApProval �
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. fiough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Dutts, in Structure 70. Underground Hydro
22. Oucts, Ventilating 71 . Product Piping O Gas O Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. S[orage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing �g-q� � W 76. Dry Standpipe
28. Lathing & Siding , 77. FIXED SYSTEM FINAL
29. Insulation � 1 78. FIRE PREV. FINAL
,
30. Drywall Nailing . HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat ' 79. FINAL INSPECTION
�
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
�
33. Final Eleciric ;�; Notes:
34. Final Heating & Air Conditioning � /2.-ZO � LZ �...- S�.e, /��, ��-
�' [
35. Final Gas Pipe-Test �+ � 6�,,� ,(�
v'•
36. Hood or Canopy i r�,r;;�
37. Final Factory Fireplace � +
38. Final Plumbing �(��(_
39. Water Service�Final '
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation SYstem �
45. Sound Attenuation
46. Handicap Regulations .
47. FINAL STRUCTURE & BUILDING `(Q ,
48. FINALPLANNING ' '
49. Electric Release to Edison � �
� 50. Gas Release ta Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
N0. Date